Patient outcomes following emergency admission to hospital for COVID-19 compared with influenza: retrospective cohort study

Abstract

BackgroundWe examine differences in posthospitalisation outcomes, and health system resource use, for patients hospitalised with COVID-19 during the UK’s first pandemic wave in 2020, and influenza during 2018 and 2019.MethodsThis retrospective cohort study used routinely collected primary and secondary care data. Outcomes, measured for 90 days follow-up after discharge were length of stay in hospital, mortality, emergency readmission and primary care activity.ResultsThe study included 5132 patients admitted to hospital as an emergency, with COVID-19 and influenza cohorts comprising 3799 and 1333 patients respectively. Patients in the COVID-19 cohort were more likely to stay in hospital longer than 10 days (OR 3.91, 95% CI 3.14 to 4.65); and more likely to die in hospital (OR 11.85, 95% CI 8.58 to 16.86) and within 90 days of discharge (OR 7.92, 95% CI 6.20 to 10.25). For those who survived, rates of emergency readmission within 90 days were comparable between COVID-19 and influenza cohorts (OR 1.07, 95% CI 0.89 to 1.29), while primary care activity was greater among the COVID-19 cohort (incidence rate ratio 1.30, 95% CI 1.23 to 1.37).ConclusionsPatients admitted for COVID-19 were more likely to die, more likely to stay in hospital for over 10 days and interact more with primary care after discharge, than patients admitted for influenza. However, readmission rates were similar for both groups. These findings, while situated in the context of the first wave of COVID-19, with the associated pressures on the health system, can inform health service planning for subsequent waves of COVID-19, and show that patients with COVID-19 interact more with healthcare services as well as having poorer outcomes than those with influenza.

Surveillance of Severe Acute Respiratory Infection and Influenza Vaccine Effectiveness among Hospitalized Italian Adults, 2021/22 Season

“…Interestingly, SARI patients positive for influenza were significantly younger than those positive for SARS-CoV-2. Similar observations have been reported from other studies carried out in the United Kingdom [ 34 ] and Brazil [ 35 ]. In Italy, older age is among the most important predictors of both SIV [ 36 ] and COVID-19 [ 37 ] vaccination uptake.…”

Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation

“…Consistent with previous research, we observed a significant association between receiving follow-up care at the primary care level shortly after respiratory infection hospitalisation and improved health outcomes. 32 This association can plausibly be attributed to several important pathways. First, timely primary care follow-up facilitates the monitoring and management of symptoms after respiratory infection hospitalisation, leading to symptoms alleviation and reducing the risk of further development of complications.…”